Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary bone tumors represent about 7% of paediatric malignancies. Osteosarcoma and Ewing's tumor are the most frequent ones, however they are rare in facial bones. Mandibular localization is slightly more frequent and of better prognosis than maxillary one. Until 1995 there were only about 70 cases reported in the medical literature, mainly in the oncological or dental periodics. Our material consists of two children with Ewing's tumor of the mandible and one patient with osteosarcoma. The diagnosis was based on histopathological or cytological studies. The combined treatment--chemotherapy and radiotherapy--was performed in two patients with Ewing's tumor. The recommended resection of the mandible including the tumor mass has not been performed. No facial asymmetry is seen after termination of the radiotherapy. The boy with osteosarcoma underwent primary mandibular partial resection; a two-year chemotherapy was introduced only when metastases in the regional lymph nodes occurred (BLM, CTX, ACT-D, ADM, CDDP). The mandible was reconstructed surgically in 5 years after termination of radiotherapy and the anatomical relationship in the masticatory organ was restored. All children are now in good condition under our long-term observation. We present these cases of mandibular tumors regarding their rare occurrence and positive results of the introduced treatment.
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PMID:[Malignant tumors of mandible in children]. 1073 62

Resection of the considerable part of the arch of the mandible disturbs breathing, swallowing, speaking and alters the facial symmetry. One-staged reconstruction of the mandible is contraindicated in patients with malignant tumor and serious prognosis. The course of the combined treatment in 9-year-old boy with osteosarcoma of the mandible is presented (May 1987--resection of the anterior part of the body of the mandible and suprahyoid lymphadenectomy); the most severe postoperative functional disorders were treated immediately (tracheostomy, nasogastric tube for 3 weeks). The reconstruction of the mandible and restoration of the anatomical relationship in the masticatory organ were performed after 5 years. Because of the metastatic disease in the nuchal and cervical lymph nodes boy underwent chemotherapy (Jan 5th 1988-Feb 21st 1990) of the primary site of the tumor 7 months after surgery. The following cytostatic drugs were administered; BLM, CTX, ACT-D, ADM, CDDP. The functional rehabilitation, small correctional surgery and improvement in perception in the oral cavity facilitated the restoration of important functions of the masticatory organ (proved by the following studies: gustometric, manometric, logopedic, stereognostic, rentgenotelevision of the swallowing process). In addition, the self-perception and the boy's social status improved significantly after favourable change in patient's appearance.
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PMID:[Functional reconstruction of the masticatory organ after combined therapy in a 9-year-old boy with osteosarcoma of the mandible]. 1073 93

Although increased bone formation is a prominent feature of patients with osteosclerotic metastases from prostate cancer, there is also some evidence for increased bone resorption. The aim of this study was to compare the clinical utility of new bone resorption markers to that of bone formation in patients with bone metastases from prostate cancer before and after bisphosphonate treatment. Thirty-nine patients with prostate cancer and bone metastasis, nine patients with prostate cancer without bone metastases, nine patients with benign prostatic hyperplasia and 355 healthy age-matched men were included. Urinary non-isomerized (alpha CTX) and beta isomerized (beta CTX) type I collagen C-telopeptides (CTX) and a new assay for serum CTX were used to assess bone resorption. Bone formation was determined by serum osteocalcin, serum total (T-ALP) and bone (BAP) alkaline phosphatase and serum type I collagen C-terminal propeptide (PICP). Fourteen patients with bone metastases were also evaluated 15 days after a single injection of the bisphosphonate pamidronate (120 mg). Levels of all bone formation and bone resorption markers were significantly (P < 0.006-0.0001) higher in patients with prostate cancer and bone metastasis than in patients with benign prostatic hyperplasia, patients with prostate cancer without bone metastases and healthy controls. In patients with bone metastases the median was increased by 67% for serum osteocalcin, 128% for T-ALP, 138% for BAP, 79% for PICP, 220% for urinary alpha CTX, 149% for urinary beta CTX and 214% for serum CTX. After bisphosphonate treatment all three resorption markers significantly decreased by an average of 65% (P = 0.001), 71% (P = 0.0010) and 61% (P = 0.0015) for urinary alpha CTX, urinary beta CTX and serum CTX, respectively, whereas no significant change was observed for any bone formation markers. Patients with prostate cancer and bone metastases exhibit a marked increase in bone resorption, which decreases within a few days of treatment with pamidronate. These findings suggest that these new resorption markers may be useful for the management of these patients.
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PMID:Markers of bone turnover for the management of patients with bone metastases from prostate cancer. 1073 59

The aim of this study was to determine if the response to preoperative radiation and chemotherapy with continuous infusion 5-fluorouracil (5-FU) was predictive for survival among patients with locally advanced rectal cancer. Preoperative chemoradiation (CTX/XRT) that delivered 45 Gy in 25 fractions over 5 weeks with continuous infusion 5-FU (300 mg/m2/day) was given to 117 patients. The pretreatment stage distribution, as determined by endorectal ultrasound (u), included uT2N0 in 2%, uT3N0 in 47%, uT3N1 in 49%, and uT4N0 in 2% of cases; endorectal ultrasound was not performed in 13% of cases (15 patients). Approximately 6 weeks after completion of CTX/XRT, surgery was performed. Adjuvant chemotherapy, consisting of 400 to 425 mg/m2 of 5-FU plus 20 mg/m2 leucovorin for 5 days, was administered every 28 days for 4 to 6 cycles after surgical resection. Among the 74 patients treated with adjuvant chemotherapy, the preoperative stage of disease was 31 with T3N0 and 43 T3N1. Median follow-up was 46 months (range 2 to 89 months). The pathologic tumor stages were Tis-2N0 in 26%, T2N1 in 5%, T3N0 in 21%, T3N1 in 15%, T4N0 in 5%, and T4N1 in 1%; a complete response (CR) to preoperative CTX/XRT was pathologically confirmed in 32 (27%) of patients. Tumor down-staging occurred in 72 (62%) cases. A sphincter-saving procedure (SP) was possible in 59% of patients. The median DFS and overall survival rates for responders were 46 months and 47 months, respectively; for non-responders these outcome measures were 38 months and 41 months, respectively. Log-rank analysis showed that the distant metastatic-free survival rates improved with any response to CTX/XRT (p < 0.00001), CR to CTX/XRT (p < 0.009) and SP (p < 0.012). Likewise, these parameters also significantly influenced DFS rates (CTX/XRT p < 0.00001; CR p < 0.006; and SP p < 0.008). Control of pelvic disease was influenced by clinical size (p < 0.002) and SP (p < 0.016) on univariate analysis. On multivariate analysis only clinical size (p < 0.002) continued to be a significant factor for local control. Factors on multivariate analysis that resulted in significant improvements in cancer-specific survival included any response to preoperative CTX/XRT (p < 0.017) and administration of adjuvant chemotherapy (p < 0.034). Any response to preoperative CTX/XRT improved distant metastatic-free and disease-free survival rates. Multivariate analysis confirmed that a response to preoperative CTX/XRT predicted for improvements in overall survival among patients with locally advanced rectal cancer. Patients who fail to respond to preoperative 5-FU based chemotherapy given concomitantly with radiation have higher rates of distant metastases with adjuvant 5-FU therapy.
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PMID:Improved overall survival among responders to preoperative chemoradiation for locally advanced rectal cancer. 1131 80

This study determined the effects of high-dose chemotherapy (HDCT) with autologous blood stem cell transplantation (ASCT) on quality of life (QL) in women with metastatic breast cancer prior to, and during treatment, and up to 1-year post-ASCT. Thirty-three women diagnosed with metastatic breast cancer participated in a phase 1 clinical trial of a new combination of cyclophosphamide (CTX) and mitoxantrone (MXT), with dose escalation of paclitaxel. Longitudinal QL data were collected using the functional living index-cancer (FLIC) and symptom scales at seven time periods: pre-induction chemotherapy (CT), post-induction CT, post-high dose CT (HDCT), and at 3, 6, 9 and 12 months post-ASCT. FLIC scores indicated that the worst problems for patients were feelings of hardship on themselves and their families, followed by psychological functioning and physical functioning problems. The time around diagnosis of the metastatic disease and following HDCT were the worst times for all levels of quality of life, but anxiety and depression symptoms continued to increase in severity across the entire follow-up period. The symptoms that were most problematic were worry about the future, loss of sexual interest, anxiety about the treatment, general worrying, and joint pain. These data highlight the problems that women with metastatic breast cancer encounter at different stages of the disease and treatment process, and can be used to tailor psychosocial interventions appropriate for treating the relevant issues at different points in time.
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PMID:Longitudinal effects of high-dose chemotherapy and autologous stem cell transplantation on quality of life in the treatment of metastatic breast cancer. 1143 11

Thirty-two women with untreated metastatic breast cancer were treated with 100 mg/M2 i.v. methotrexate (MTX), 600 mg/M2 5-fluorouracil (5FU) and leucovorin 15 mg orally every 6 hr, 24 hr after MTX (MFL) on days 1 and 8 every 28 days. Stratification was according to sites of metastases (mets), adjuvant (adj), chemotherapy (CTX), and/or hormonal therapy or no adj therapy (Tx). Treatment continued until documented radiographic or clinical disease was in progression. Toxicity was mild, consisting of only minimal elevations of transaminases and mild cytopenias. There was no pulmonary toxicity. There were no hospitalizations, treatment delays or cessations for toxicity. One patient with skeletal mets had a complete response and 7 had partial responses. The overall median progression free survival (PFS) was 13.8 months (mos). Eighteen patients with skeletal mets had PFS from 7-70 mos (median 15.9). Five patients with lung mets only had PFS from 6-20 mos (median 9.8 mos). Patients with liver alone or with other visceral mets showed progression within 2-5 mos. However, patients with bone and visceral mets without liver involvement had PFS from 8-50 mos (median 20.5). Of 21 adj Tx failures the median PFS was 8.8 mos (2-94). Six who received adj CTX had a median PFS of 7.6 mos (3-12) and 4 tamoxifen (tam) failures a median PFS of 11 mos (8-15). Eleven patients who received adj CTX+tam had a median PFS of 8.5 mos (2-94). Six patients received tam at adj failure and MFL at progression. These six had a median PFS of 19.8 mos (8-50). The patients (six, who received no prior adj Tx) had a median PFS of 24.3 (8-70). MFL is as effective in achieving clinical remissions in metastatic breast cancer, is inexpensive and is far less toxic than other CTX regimes. MFL should strongly be considered as first line Tx.
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PMID:Experience with methotrexate, 5-fluorouracil, and leucovorin (MFL): a first line effective, minimally toxic regimen for metastatic breast cancer. 1185 98

To examine the effect of estradiol (E(2)) without the confounding effect of hypothalamic-pituitary feedback, we studied men with prostate cancer in whom gonadotropin secretion was suppressed by LH-releasing hormone agonists (LHRH-A). Fourteen men over 65 yr of age and receiving established LHRH-A treatment (EST group) without bony metastases and 12 men who received LHRH-A as neoadjuvant therapy for locally advanced prostate cancer (NEO group) were randomized (double blind) to receive either 1 mg/d micronized E(2) (n = 12) or placebo (PL; n = 13) for 9 wk. E(2), estrone, testosterone, SHBG, PTH, and 25-hydroxy- and 1,25-dihydroxyvitamin D levels as well as markers of bone resorption [N- and C-telopeptide cross-links (NTX and CTX) and deoxypyridinoline] and bone formation (bone-specific alkaline phosphatase, osteocalcin, and N-terminal type I collagen) were measured before LHRH-A in the NEO group, before [baseline (BL)] and after 9 wk of E(2) or PL in all patients, and 6 wk after E(2) treatment in the EST group. In the NEO group, hormone levels fell 3 wk after the initial LHRH-A injection, and deoxypyridinoline increased significantly (P = 0.006). At BL, the EST group had higher bone turnover due to the longer duration of LHRH-A treatment. With E(2) treatment, E(2) levels rose into the normal male range, and two resorption markers decreased significantly from BL by 33% for NTX (P < 0.001) and 28% for CTX (P = 0.009). Bone formation markers did not change. PTH increased by 43% from BL (P < 0.01) in the E(2) group and decreased 16% from BL in the PL group (P < 0.01). Ionized calcium did not change in the E(2) group, but increased in the PL group by 2.3% (P < 0.01). NTX and CTX increased 6 wk after E(2) withdrawal in the EST group. We conclude that E(2) inhibits bone resorption in hypogonadal men through a direct skeletal effect that is independent of PTH. Low dose estrogen may be an option for the prevention and/or treatment of bone loss in this population.
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PMID:The effect of micronized estradiol on bone turnover and calciotropic hormones in older men receiving hormonal suppression therapy for prostate cancer. 1241 49

Degradation products of collagen type I can be measured by CrossLaps (CTX) immunoassays, providing an index of bone resorption. The CTX epitope EKAHDGGR comprises a DG-motif susceptible to post-translational modifications. In newly synthesized collagen this motif is in the native form denoted alphaCTX, but converts to an isomerized form (betaCTX) during aging of bone. Furthermore, the lysine residue (K) within the CTX epitope participates in inter-molecular cross-links in mature bone. The present paper describes an assay, ALPHA CTX ELISA for measurement of cross-linked alphaCTX molecules (alpha-alphaCTX) in urine. The ALPHA CTX ELISA demonstrated a high specificity and technical precision for measuring such fragments. The assay was evaluated in a cross-sectional study, comparing the urinary excretion of the marker in 100 breast cancer patients with bone metastases (BC+) and 15 breast cancer patients without metastases to bone (BC-) as well as 31 age-matched healthy post-menopausal women (PM). For comparison alpha, beta, and beta-betaCTX was also measured using commercially available immunoassays. In BC+ urinary alpha-alphaCTX increased significantly compared to BC- and PM with p-values of 0.005 and <0.0001, respectively. In contrast, the age-modified form beta-betaCTX, representing the degradation of old bone, was less increased. Z-score analysis was used to compare the ability of the CTX markers to discriminate between BC+ and PM. The alpha-alphaCTX marker was found to provide a far better discrimination (Z=7.5) than beta-betaCTX (Z=3.6). In conclusion, measurement of alpha-alphaCTX fragments may provide a clinically relevant assessment of bone resorption related to bone metastases.
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PMID:An immunoassay for measuring fragments of newly synthesized collagen type I produced during metastatic invasion of bone. 1520 36

Our aim was to assess the diagnostic accuracy of bone markers in serum of patients with prostate cancer (PCa) for early detection of bone metastases and their usefulness as predictors of PCa-caused mortality. In sera of 117 PCa patients (pN0M0, n = 39; pN1M0, n = 34; M1, n = 44), 35 healthy men and 35 patients with benign prostatic hyperplasia, bone formation markers [total and bone-specific alkaline phosphatase (tALP, bALP), amino-terminal procollagen propeptides of type I collagen (P1NP), osteocalcin (OC)], bone resorption markers [bone sialoprotein (BSP), cross-linked C-terminal (CTX) and cross-linked N-terminal (NTX) telopeptides of type I collagen, tartrate-resistant acid phosphatase isoenzyme 5b (TRAP)] and osteoclastogenesis markers [osteoprotegerin (OPG), receptor activator of nuclear factor kappaB ligand (RANKL)] were measured. tALP, bALP, BSP, P1NP, TRAP, NTX and OPG were significantly increased in PCa patients with bone metastases compared to patients without metastases. OPG showed the best discriminatory power to differentiate between these patients. Logistic regression analysis resulted in a model with OPG and TRAP as variables that predicted bone metastasis with an overall correct classification of 93%. Patients with concentrations of OPG, P1NP, tALP, bALP, BSP, NTX, TRAP and CTX above cut-off levels showed significantly shorter survival than patients with low marker concentrations. Multivariate Cox proportional hazards regression revealed that only OPG and BSP were independent prognostic factors for PCa-related death. Thus, the importance of serum OPG in detecting bone metastatic spread, alone or in combination with other bone markers, and predicting survival in PCa patients has been clearly demonstrated.
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PMID:Comparison of 10 serum bone turnover markers in prostate carcinoma patients with bone metastatic spread: diagnostic and prognostic implications. 1525 51

The aim of this study was to investigate whether the local induction of pro-inflammatory cytokines in mouse lungs would increase the therapeutic effect of cyclophosphamide (CTX) used to treat experimental B16(F10) melanoma lung metastases. CTX shows antiangiogenic properties and inhibits the growth of metastases, albeit without numerical reduction. To destroy small metastases remaining after CTX treatment, pro-inflammatory cytokines were induced by systemically administering plasmid DNA-PEl polyplexes. The CpG sequences present in plasmid DNA are immunostimulatory, i.e. they induce pro-inflammatory cytokines, such as IL-12, TNF-alpha, IFN-gamma and IFN-alpha. The latter has great therapeutic potential as it activates NK cells directly involved in eliminating metastatic foci. Our data indicated, for the first time, that combining cyclophosphamide delivery and local induction of pro-inflammatory cytokines in the lungs with plasmid DNA resulted in reduction in the size of malignant melanoma metastases and their number in mouse lungs. Both effects appeared to contribute to a significant extension of survival.
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PMID:Plasmid DNA-induced cytokines together with cyclophosphamide decrease size and number of melanoma lung metastases. 1682 41


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